Lung cancer patients with leptomeningeal metastases (LMs) suffer from severe clinical symptoms, poor quality of life, narrow diagnostic and therapeutic time windows, low response to standard treatments, short survival periods, and poor prognoses. At present, there is a lack of precise diagnosis and treatment pathways and relevant consensus for LMs of lung cancer. In order to better guide the clinical diagnosis and treatment of LMs of lung cancer in an early, reasonable, and safe way, the experts of the Neurological Tumor Specialist Committee of the Chinese Society of Clinical Oncology (CSCO) have formulated this consensus based on the actual diagnosis and treatment of LMs of lung cancer in China, with reference to the latest research data, relevant guidelines and consensus, and the experts' clinical experience, as well as the results of experts' polling on the pre-set issues of LMs. The consensus focuses on diagnosing LMs, stratified management, efficacy evaluation systems, treatment strategies, common complications, and palliative care. It gives recommendations in each of the five aspects to provide clinicians with suggestions and references for diagnosing and treating LMs in lung cancer.